It’s understandable to feel concerned if you notice an unusual vaginal odor. Many women feel embarrassed to talk about it, but vaginal odor is a common experience. Getting familiar with your body and what’s normal for you is the first step in identifying when a smell might indicate a problem that needs medical attention.
Dr. Rosén, a specialist in gynecology and obstetrics, explains, “The vagina naturally contains bacteria, known as vaginal flora, which plays a crucial role in maintaining a healthy balance.” This natural bacterial environment is why cervical mucus, which is present in the vagina, always has a scent. You might also observe changes in vaginal odor throughout your menstrual cycle due to fluctuations in the vagina’s pH balance.
So, what is considered a normal vaginal smell?
According to Dr. Rosén, a healthy vaginal odor typically ranges from slightly tangy or sour to a metallic scent, especially around or after menstruation. “Generally,” she reassures, “if you feel well and your vaginal odor or discharge is typical for you, there’s usually no need for concern.”
However, if you’re worried about a particularly strong or unpleasant vaginal odor, it’s important to understand the potential causes. Here are 8 common reasons for vaginal odor and guidance on when it’s time to consult a healthcare professional:
1. Bacterial Vaginosis (BV)
Vaginal odor: Fishy
Bacterial vaginosis (BV) is a very frequent cause of a smelly vagina, affecting a significant portion of women of reproductive age. Dr. Rosén clarifies, “BV occurs when there’s an imbalance in the natural vaginal bacteria.” Often, the first noticeable symptom is a fishy vaginal odor, which can be accompanied by a frothy, greyish-white or greenish vaginal discharge. You may also experience vaginal itching and swelling.
If BV symptoms don’t resolve on their own, various treatment options are available. “A doctor can prescribe antiseptics or antibiotics,” Dr. Rosén advises. Unfortunately, BV recurrence after antibiotic treatment is common. Some studies suggest probiotics may be beneficial. Dr. Rosén also recommends considering a change in contraception, particularly if you are using an intrauterine device (IUD).
She also points out that your sexual partner’s hygiene could contribute to recurrent infections. Discussing personal hygiene and using condoms (both external and internal) for a period might be helpful. If this approach improves the situation, your partner may also require antibiotics.
“If you experience these symptoms,” Dr. Rosén emphasizes, “it’s important to see a doctor to rule out any other underlying conditions that might require treatment.” This is especially critical during pregnancy, as BV can increase the risk of premature labor.
2. Trichomoniasis
Vaginal odor: Pungent and fishy, similar to BV
Trichomoniasis, often called “trich,” is the most prevalent non-viral sexually transmitted infection (STI) globally. Dr. Rosén explains, “Trichomoniasis is caused by a parasite and often doesn’t cause significant symptoms.” However, some individuals may experience subtle symptoms like a yellowish-green vaginal discharge with a noticeable unpleasant smell. The vulva might also become slightly red and itchy. Typically, a course of antibiotics effectively treats trichomoniasis.
3. Toxic Shock Syndrome (TSS)
Vaginal odor: Very unpleasant, but odor is usually a minor symptom
Toxic shock syndrome (TSS) is now a rare condition, previously linked to highly absorbent tampons. “If the bacteria that cause TSS enter your bloodstream, it can lead to rapid and severe illness. Symptoms include high fever, sudden changes in blood pressure, potentially a rash, diarrhea or vomiting, and feelings of faintness,” Dr. Rosén describes.
“If you develop these symptoms, seek immediate medical attention at the emergency room. TSS is very uncommon today,” she reassures.
4. A Forgotten Tampon
Vaginal odor: Extremely unpleasant
“There are cases where women seek medical advice for a strong vaginal odor, only to discover it’s due to a tampon left in place for days, or even longer,” Dr. Rosén notes.
“If this happens, the odor will worsen rapidly and become very noticeable and offensive. If you experience a vaginal odor that intensifies quickly, it’s always wise to check for a forgotten tampon.”
5. Vaginal Thrush (Yeast Infection)
Vaginal odor: Yeasty
Vaginal yeast infections, also known as thrush, are very common and typically cause itching, burning, and changes in vaginal discharge. The discharge often becomes thick, white, and resembles cottage cheese.
While thrush is known for these symptoms, it doesn’t usually cause a strong odor. “If thrush symptoms are severe and accompanied by a bad smell, it’s best to consult a doctor to rule out any other underlying conditions,” Dr. Rosén advises.
6. Hormonal Changes
Vaginal odor: Varies
Similar to the odor changes experienced during the menstrual cycle, other hormonal shifts can affect vaginal scent. “During menopause and post-menopause, vaginal odor can change,” Dr. Rosén states.
Pregnancy also alters cervical mucus. “You might notice increased discharge, or it may become thicker or thinner, but it shouldn’t have a foul smell,” Dr. Rosén explains. “If you are pregnant and have a smelly discharge, you should consult your doctor or midwife.”
7. UTIs and Other Urinary Issues
Vaginal odor: Ammonia-like
An ammonia-like vaginal odor may indicate the presence of urine, potentially related to a urinary tract infection (UTI). “This is more likely if a UTI goes untreated and you experience urine leakage,” Dr. Rosén explains. “An untreated UTI can also cause fever, and the odor will be distinct and sickly.”
Sometimes, an ammonia smell can also signal an existing urinary incontinence issue that you might not be aware of, Dr. Rosén adds. “Urinary incontinence is very common, and a doctor or gynecologist can provide advice on treatment options.”
8. Gynecological Cancers
Vaginal odor: Metallic and sickly
In rare cases, a foul-smelling vaginal discharge can be a symptom of cervical or uterine cancer. However, vaginal odor and discharge are unlikely to be the only or initial symptoms.
“You might experience bleeding after intercourse or occasional spotting that becomes more frequent. The odor may be slightly metallic,” Dr. Rosén describes. “This smell is quite different from the fishy or rotten smells associated with BV or a forgotten tampon.”
If you experience unusual vaginal bleeding, it’s crucial to consult a doctor.
Can STIs Cause Vaginal Odor?
“STIs like chlamydia and gonorrhea rarely cause a noticeable change in vaginal odor but can cause other symptoms, such as pain when urinating,” says Dr. Rosén. “If you do notice an odor, it could be that you also have bacterial vaginosis. If you’re unsure, it’s always best to seek medical advice.”
How to Manage Vaginal Odor
Many women concerned about vaginal odor want to know the best vaginal smell treatments, washing routines, or feminine washes for odor.
“Like any area of the body prone to sweating, the vulva area can develop a smell,” Dr. Rosén explains. However, using soaps can disrupt the delicate balance of vaginal bacteria and potentially increase the risk of bacterial vaginosis. Douching, which involves rinsing out the vagina, can also have the same negative effect.
The recommended approach for washing the vulva is simply using water and avoiding perfumed sanitary pads or vaginal deodorants.
“If you experience vaginal dryness due to breastfeeding, vaginal atrophy (thinning, drying, and inflammation of vaginal walls, often due to lower estrogen levels), or a recent infection, you can use vaginal moisturizers – but choose fragrance-free options.”
When to Consult a Doctor About Vaginal Odor
It’s crucial to recognize what is abnormal for your body and scent.
Starting with simple lifestyle adjustments, such as washing with water only and avoiding scented products, is a good first step. While some home remedies for vaginal odor, like consuming pineapple or pineapple juice, are popular, their effectiveness varies and may not work for everyone.
However, if the vaginal odor worsens or you experience other symptoms, it’s important to speak to a doctor.
This article has been medically reviewed and approved by Dr. Elisabeth Rosén, a medical doctor at Livi specializing in gynecology and obstetrics.
